Project Summary?Overall We propose a national infrastructure center entitled ?Center for Smart Use of Technologies to Assess Real- World Outcomes (C-STAR)? that directly addresses priority area #6 from RFA HD-20-04: ?Technology to Track Real-World Outcomes.? Leveraging the collective experience of our clinicians, scientists, engineers, and patients, our program will provide the expertise, instruction, and mentoring to support the smart (i.e., appropriate, accurate, and clinically meaningful) use of technology to assess performance in the laboratory (e.g., by providing design insight for a new sensor), in the clinic (e.g., by teaching proper selection and placement of sensors on a patient's body) and in the community (e.g., by guiding investigators on appropriate, validated patient reported outcome measures to evaluate technology). By measuring performance across these domains, rehabilitation researchers and clinicians will be able to both track real-world outcomes and investigate mechanisms underlying response to therapy or disease progression. A compelling need for rehabilitation research infrastructure exists in this area because of: (1) the huge proliferation of sensors and other technologies that make it easy to ?acquire data? without the necessary expertise to validate, interpret, and establish the clinical relevance of these data, (2) the need to quantify and standardize outcomes?to not just understand clinical outcomes but to provide important economic and societal perspectives, and (3) the need to customize, validate, standardize, and calibrate technologies in the context of specific patients' needs and abilities, which often requires access to particular patient cohorts. Our four cores?engineering, clinical, outcomes, and implementation Science/community engagement?will provide the necessary expertise to allow C-STAR clients to develop, test, validate, and standardize the use of new and existing technologies to track real-world outcomes across many disabling conditions. C-STAR clients will be individuals or teams who would like to use technology to measure performance of individuals with physical disabilities. We will provide numerous didactic, hands-on, visitation, pilot funding, and advisory resources to support C-STAR clients. We will connect with our clients through our C-STAR website and our proprietary Rehabilitation Measures Database (RMD) website (www.rehabmeasures.org) that currently averages 11,000 unique page visits per day from likely C-STAR clients. The resources C-STAR offers to the rehabilitation community include its leaders, who have 20 years of cumulative experience with the R24 national infrastructure network, and other senior scientists who experienced in the application of technology to help medical rehabilitation patients and mentorship of junior researchers. C- STAR exploits the extraordinary environment and resources of our new translational research hospital, the Shirley Ryan AbilityLab (SRAlab, formerly the Rehabilitation Institute of Chicago, RIC) as well as the collegial and fruitful collaborations developed over the past 30 years between the RIC/SRAlab and Northwestern University.